Health care access and health-related quality of life among people with diabetes in the Southern Cone of Latin America—a cross-sectional analysis of data of the CESCAS I study

Abstract

Purpose: Little is known on the association of health care access and health-related quality of life (HRQoL) in people with diabetes in the Southern Cone of Latin America (SCLA). Methods: We analyzed data of 1025 participants of CESCAS I. To determine HRQoL, we used the SF-12 physical (PCS-12) and mental component summary (MCS-12). We compared four groups regarding HRQoL: (a) insured people without self-reported barriers to health care, (b) uninsured people without self-reported barriers to health care, (c) insured people with self-reported barriers to health care, and (d) uninsured people with self-reported barriers to health care. We conducted linear regressions with PCS-12 and MCS-12 as outcome. We adjusted for sociodemographic and disease-related factors and having access to a primary physician. Results: In the first group, there were 407, in the second 471, in the third 44, and in the fourth group 103 participants. Compared to the first group, PCS-12 was 1.9 points lower (95% Confidence Interval, CI: − 3.5, − 0.3) in the second, 4.5 points (95% CI: − 8.1, − 1) lower in the third, and 6.1 points lower (95% CI: − 8.7, − 3.6) in the fourth group. Compared to the first group, MCS-12 was 0.6 points lower (95% CI: − 2.7, 1.4) in the second, 4.8 points lower (95% CI: − 9.3, − 0.3) in the third, and 5.8 points lower (95% CI: − 9.1, − 2.5) in the fourth group. Conclusion: In the SCLA, impeded access to care is common in people with diabetes. Self-reported barriers to care may be more important than insurance status in determining HRQoL.